Primary Lymphoma of the Distal Femur Presenting as Spontaneous Deep Vein Thrombosis and Knee Monoarthritis: A Case Report

Hulaimatu B Jalloh; Shivani Ahlawat; John M Gross; Adam S Levin; Richard A Schaefer

doi:10.2106/JBJS.CC.21.00402

Primary Lymphoma of the Distal Femur Presenting as Spontaneous Deep Vein Thrombosis and Knee Monoarthritis: A Case Report

JBJS Case Connect. 2021 Sep 9;11(3). doi: 10.2106/JBJS.CC.21.00402. eCollection 2021 Jul 1.

Authors

Hulaimatu B Jalloh¹, Shivani Ahlawat², John M Gross³, Adam S Levin¹, Richard A Schaefer¹

Affiliations

¹ Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland.
² Department of Radiology, The Johns Hopkins University, Baltimore, Maryland.
³ Department of Pathology, The Johns Hopkins University, Baltimore, Maryland.

PMID: 37556822
DOI: 10.2106/JBJS.CC.21.00402

Abstract

Case: A 68-year-old man with a history of unprovoked deep vein thrombosis (DVT) presented with recurrent knee effusions after the initiation of anticoagulation. Radiographs showed soft-tissue swelling without a distinct skeletal lesion. Magnetic resonance imaging, however, showed a marrow-replacing process in the distal femur. Subsequent biopsy demonstrated B-cell lymphoma.

Conclusion: This is a rare case of a primary lymphoma of bone mimicking synovial disease. It also highlights the fact that an unprovoked DVT may be a harbinger of an undiagnosed underlying malignancy.